National Provider Identifier [NPI]: |
1326085325 |
Last Name Of The Provider |
COWAN |
First Name Of The Provider |
IAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11315 BRIDGEPORT WAY SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
984993004 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1115 |
Number Of Medicare Beneficiaries |
557 |
Total Submitted Charge Amount |
509781 |
Total Medicare Allowed Amount |
105293.59 |
Total Medicare Payment Amount |
80677.02 |
Total Medicare Standardized Payment Amount |
82194.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1115 |
Number Of Medicare Beneficiaries With Medical Services |
557 |
Total Medical Submitted Charge Amount |
509781 |
Total Medical Medicare Allowed Amount |
105293.59 |
Total Medical Medicare Payment Amount |
80677.02 |
Total Medical Medicare Standardized Payment Amount |
82194.34 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
317 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
522 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
351 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.696 |